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August 6, 2008

Why Insurance Companies Cover Viagra But Not Birth Control

When I told Adam that I was writing something about the whole Viagra/birth control/insurance situation, he decided to write his own take on the issue. As you'll see when you read, it's pretty much the opposite of my view, but he's also approaching this from a different angle than I did, and addressing some things from the point of view of the insurance companies. It's certainly a perspective that's worth examining even if you don't entirely agree. Of course, we also had a huge debate about this because I had to try to explain to him why he's wrong and I'm right, and we're going to entertain you with a portion of that debate tomorrow.


There has been a controversy for some time now surrounding health care companies' coverage of Viagra. Paying for a drug which gives men potency (and therefore the ability to have sex) while not covering birth control for women seems hypocritical and irresponsible.

It is not.

And while I disagree (I think BC should be covered), I can see why they wouldn't. Sometimes.

Medical Reasons

Pregnancy: The state of carrying a developing embryo or fetus within the female body.

Pregnancy, as defined by the medical community and medterms.com, is not a harmful medical condition. While it may be something to avoid for social or economic reasons, becoming pregnant is not something to avoid for health concerns. At least in most women. As such, measures used to prevent pregnancy are not covered by most medical insurance companies. Condoms, and other forms of disease prevention, are often covered due to the fact that they can prevent disease, not pregnancy.

Viagra: virility drug (trade name Viagra) used to treat erectile dysfunction in men

Erectile Dysfunction: A common men's health problem characterized by the consistent inability to sustain an erection sufficient for sexual intercourse or the inability to achieve ejaculation, or both.

Erectile Dysfunction is a medical condition where part of the body no longer functions as it should. Viagra treats that. The fact that it treats dysfunction in an organ that many men base their psyche and social calendars on is irrelevent (at least medically).

The comparison of Viagra to Birth Control is not a direct one. One treats a medical condition, a failure in the body. The other, most of the time, is a preventative measure to stop another completely healthy condition from coming about. The only case where the comparison is apt is in cases where birth control is a medical necessity due to chronic pelvic pain or recurrent ovarian cysts (for example).

Cost

Here is where we get a little more fuzzy, ethically. When you break down the costs of insuring birth control, it's just not profitable. It is an ongoing cost that does not treat a medical condition, and could potentially be claimed by a large (~50% + spouses/children) portion of the insured. In a world where the bottom line is an increasingly important issue, there is no financial reason to provide birth control as part of insurance. In fact, there are several valid reasons against it.

Social

There are tons of great social reasons to insure birth control, for the individual and for society. Unfortunately, none of them matter to insurance companies. They're not in the business of making social change. They're in the business of making money. The only reason an insurance company would switch to covering birth control is if they were forced by the government or if a large demographic of people refused to buy insurance from any one who didn't provide such coverage. Either one requires a large group of dedicated individuals to make their voices known.

Do you think birth control should be easily affordable? Write your congressional representatives and your insurance company. Get your friends to write. The more people who push for this to happen, the more likely it is. God knows we need it to happen. And while you're at it, please include a paragraph or two on why real sex education is necessary.


So what do you all think? Obviously Adam's take here doesn't represent the views of the rest of the ESC, but it did give us some things to think about. Stay tuned for some hot debating action tomorrow.

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14 comments:

May said...

I'd buy your argument if it weren't for the fact that OTHER preventative measures like vaccinations and check-ups are covered by health insurance. They certainly aren't addressing any harmful medical condition as you say birth control doesn't, but they are still covered! The blatant stigma is against women having full access to the services they need for reproductive control. I don't think there's any excuse for it.

Adam said...

Vaccinations and check-ups DO address harmful medical conditions... ahead of time. I'm not sure where you were going with that.

I know that pregnancy IS dangerous for some women, and if there is certain predictable risk I think the insurance companies should cover the prevention.

I want to reiterate that I think they should cover BC for other reasons, but as it stand now I see why they don't.

Jezebel said...

Well, I think part of May's point is that you can make a good argument that birth control is preventative care, just like something like a vaccine that is covered. And if you accept that argument, it makes a lot less sense to claim that the only reason BC isn't covered is because it doesn't directly treat a medical condition like Viagra does.

Adam said...

There is a HUGE difference between a preventative measure that stops you from getting smallpox, and one that stops you from getting pregnant.

Preventative measures (currently) should only covered if what they prevent is a harmful medical condition.

Lilith said...

Well okay, birth control isn't just for pregnancy prevention. As Target Women reminds us, birth control is also "period control". ;-)

It doesn't seem fair that women should have to prove that they need birth control for other reasons in order to get it covered. I mean, there normal conditions like cramps or irregularity, that aren't "harmful" conditions, but something that it'd be nice to have the option to fix.

Karen said...

If insurance companies only cover preventative care for conditions they deem harmful, why do they cover pregnancy costs at all? If they're going to say pregnancy isn't harmful, why cover it?

ozymandiaz said...

Blah blah blah. You can wrap "reasons" around a pile of shit and call it dinner if you want but lets get down to brass tacks. The insurance agencies are run by men and to men hard dicks (virility) and babies (virility) are of paramount importance to their insecurities. Erectile dissfunction is most often caused by lifestyle (diet, substance abuse, sleeping habits) or by medical conditions created by the aformentioned lifestyles. And no, pregnancy is not a harmful medical condition but once you get pregnant they sure treat it that way.
This is all bullshit. This is the axis of evil here folks, insurance-hospital-pharmaceutical. It is a highly profitable manage' trois. Women's healthcare in general lags way behind men's although things are getting better but we still have this male oriented western medecine bohemouth to deal with.

ozymandiaz said...

p.s.
also must look at why insurance companies cover breast implants which has no medical benefit at all but will not cover breast reduction. My cousin had breasts so large she continually lost her balance and had habitual back issues. No help from insurance there.

Adam said...

Actually, I would call cramps and irregularity, at least past a certain point, harmful.

I think the bigger issue that that there is a tremendous lack of understanding about female specific conditions. Things like cramps, irregularity, hormonal imbalances, inability to get aroused or reach orgasm. Due to the obvious visual nature of the problem (and a male dominated society), men's issues have been well documented for a long time. A better effort needs to be made to understand common women's issues.

Unfortunately, I don't have a good solution for insurance companies in the meantime. I'd say start your own company that insures single women and covers birth control. Work out the costs ahead of time, and if you can make it viable, go for it. I'll be a lot of women around the country would be interested, and you'd get lots of free publicity.

Adam said...

p.s. ozymandiaz - Completely with you there. I'm not saying insurance companies don't do stupid shit.

Lilith said...

Does health insurance really cover breast implants!? I don't know if that's typical of most insurance companies. Maybe they cover it, because like viagra, breast implants help men get erections. ;-)

Anonymous said...

It is a bit undermining to say that pregnancy is not a dangerous condition. The reason going into labor is so painful is because the fetus grows face down inside of the woman. In primates the fetus comes out face up, so the baby can be held by its mother upon retrieval. But this is not the case in humans, so a lot of assistance is needed in child bearing because the mother is left so vulnerable.

عفراء said...

I know this is an old post and I need to do some research to see if this situation has changed since this posting, but regarding the financial cost to insurance companies of BC, it is far far more expensive to the insurance company to cover an unwanted pregnancy (doctor visits, sonograms, diagnostic tests, hospital stay, doctor's/nurse's/midwife's fees).

Considering the cost of covering a pregnancy, it is more cost effective for insurance companies NOT to cover meds for erectile dysfunction. Thus it seems that it is not at all a "cost assessment" that is motivating the insurance companies to cover the meds but not BC.

The argument about cost effectiveness cannot be separated from the arguments about social judgment/imposed morality.

Also, do the insurance companies cover abortions in the case of unwanted pregnancy? Whether yes or no, is that a decision based solely on cost effectiveness?

~~bint

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